The Japanese Journal of Clinical Dialysis Vol.25 No.1(2-2-2)

Theme Controlling Infections in Dialysis Patients
Title Hepatobiliary tract infection in dialysis patients
Publish Date 2009/01
Author Koji Ito Department of Surgery and Blood Purification Center, Iwamizawa Municipal General Hospital
Author Motohiro Uno Department of Surgery and Blood Purification Center, Iwamizawa Municipal General Hospital
Author Ryoji Yokoyama Department of Surgery and Blood Purification Center, Iwamizawa Municipal General Hospital
Author Yoh Kamiizumi Department of Surgery and Blood Purification Center, Iwamizawa Municipal General Hospital
Author Kenji Abe Department of Surgery and Blood Purification Center, Iwamizawa Municipal General Hospital
[ Summary ] Hepatobiliary tract infections such as liver abscesses, cholangitis or cholecystitis may lead to sepsis or multiple organ failure. Dialysis patients are known to be at risk of infection, cardiovascular disease and hemorrhaging. In this report, we examined hepatobiliary tract infections in dialysis patients in our dialysis unit over a ten years period. Nine patients were treated (one with cholangitis due to bile duct carcinoma, two with acute cholecystitis and with six chronic cholecystitis). Biliary tract drainage was done in two cases. One 73-year old male exhibited bile duct carcinoma. He experienced many complications, so only endoscopic stenting was done. He died nine months later due to carcinoma. Another is 72-year old female, had acute cholecystitis. She was treated with percutaneous transhepatic gallbladder drainage. Further procedures were not done because she had mild dementia and breast carcinoma. Further complications have not been seen for the past 11 months. Additional procedures have been developed to treat recurrent cholecystitis if it should occur. We performed cholecystectomies in other seven cases (one acute and six chronic cholecystitis). Postoperative complications were seen in only one case (wound hernia), and other cases, which were not eventful. We concluded that dialysis patients can be treated with nearly the same procedures as non-dialysis patients.
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